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Friday, December 9, 2011

Knuckleheads on the Internet Again


This blog is a response to the article referenced above. And, pardon my language, but I'm pissed off about it. The science of immunology is highly complicated, and vaccinating dogs and cats is serious business. There is a LOT of gray area here. It offends me when someone who owns a dog and has a computer "publishes" a report describing "millions of people" who have lost their companion animals due to "unscientific, unsafe, and unnecessary vaccinations."

Really? It's that simple? Well, it must be true - they even have pictures and videos! The thing all these dogs had in common? Vaccines! So...using that logic, I could "prove" how hundreds of dogs I have seen with horrible, miserable skin disease were doomed because they went to a GROOMER!! Even after their diagnosis, they still got GROOMED! The horror! What about the hundreds of dogs I've seen with hip dysplasia who all went to DOG PARKS?! And the atrocities I've seen from dogs who were fed DOG FOOD!! Do you get my point?

Vaccines are not innocuous. They can do harm. I agree with that. That's why I have spent literally hundreds of hours reviewing veterinary journal articles and texts, as well as speaking with credentialed researchers on the subject. I'm sorry, but I think I have a little more credibility than anonymous internet blogger guy (or girl). Our knowledge of vaccines is continously evolving. My practice changes our recommendations as new information becomes available.

A lot of our information comes from people like Ron Schultz and Richard Ford who are referred to in the "Death By Vaccinosis" article. The anonymous author of the article states that Drs Ford and Schultz "don't recommend the Lepto vaccines." That's interesting, because I have a copy of a paper written by Dr Ford in 2010 in which he recommends the Lepto vaccine where risk of exposure exists (2010 Vaccines and Vaccination: Issues and Controversies). Drs Ford and Schultz both sat on the American Animal Hospital Association Canine Vaccine Task Force, whose vaccine recommendations are followed by mine, and many other veterinary hospitals. I wonder how they feel about having their opinions distorted by this knucklehead?

I am sure there are neglegent veterinarians. I know of veterinarians who vaccinate for everything they possibly can. This is wrong. I am sorry for their patients and clients. But the overwhelming majority of us make vaccine recommendations based on the most current knowledge, and with our patients' welfare as the only consideration. We vaccinate our own pets in the same manner as which we recommend for our patients. We may change those vaccination recommendations as new information becomes available, but I'm extremely comfortable stating that vaccines have spared exponentially more suffering than they have caused.

Wednesday, November 30, 2011

My Daily Prayer For Work

Here is the prayer I started saying every morning before work, ever since I became a veterinarian. It's kind of a personal thing, but since there's only 23 of us, I thought it would be safe to share. :-)

Dear God, please guide my hands and my mind as I work today, so that all that I say, and all that I do, will be of maximum benefit to my patients and clients. Amen.

Wednesday, November 23, 2011

Things This Veterinarian Is Thankful For

Chemotherapy for dogs (& cats, although I've never done a cat)

Fantastic flea products, so I don't have to send home grocery bags of spray, bombs, and treatment schedules

Humane organizations, who are so compassionate and giving of their time and energy- I am humbled to get to help these wonderful people help pets

Surgical lasers: less bleeding, less pain

Digital Xray systems -- I remember when we used to take Xrays, then go into the darkroom to dip them in developer, then hang them up to dry. It would take about 10-15 minutes per film, and if they were bad, we'd have to repeat the whole process. Now? 60 seconds per film, and digitally manipulate it if it's under- or over-exposed

Animal emergency clinics -- no more trips to the clinic at 2:00AM for me!

My hospital team -- compassionate, dedicated, talented

Wet tongues and wagging tails

Cerenia: the Parvo puppy's best friend

Convenia: no more antibiotic pills for sick cats. One shot, and we're good for two weeks!

Black & white cats -- my favorites!

Pet insurance

Care Credit

A really understanding wife and kids who were willing to share a BIG part of me these past 24 years

Happy Thanksgiving everyone!!!

Friday, October 21, 2011

Dog Days

This one is going to be a simple update on the latest goings-on at Horseshoe Lake Animal Hospital. No agenda, no specific teaching points. My English professors would hate this! But it IS a blog, and not an essay, so....

We have seen several dogs with proptosed ("popped out") eyes in the past week. Gruesome. Usually this happens in flat-faced dogs with head trauma. Most of the time the eye is so badly damaged that we have to remove it. What is amazing is that these little guys seem really chipper in spite of their horrible appearance. The indomitable dog: one of the reasons I'm glad to take care of pets and not people.

We've also seen our share of cardiac problems lately. There are so many great diagnostic tests available for heart disease now, but it is still tricky to diagnose in some cases, much to my frustration. There is also an exciting new drug called Vetmedin for the treatment of canine heart failure. We've been prescribing it a lot lately!

Allergic ear, skin, and respiratory disease seems to be a year-round problem. As the seasons change, we see a new group of dogs (and cats) whose allergens rise in that particular season. The "summer allergy" pets are finally getting some relief, but it's been a rough fall for the "autumn allergy" gang.

Speaking of relief, how about those Cardinals? The bullpen finally lost a game for us last night, but otherwise the relief corps has been over-achieving. It is thrilling to live in St. Louis when the Cards are in the post-season. We are wearing Cardinals apparel every Friday to support the home team. Dr. Randla supported his hometown Phillies when we played them, but even he is on board now.

We received a surprise visit from Pastor Sig Bjorklund and members of St Lukes United Methodist Church on Wednesday. They brought in breakfast and a certificate for going "above and beyond" in our work here. It was really heartwarming to see the "heros" who work so hard here get some recognition. Some of them were brought to tears. On Thursday, I was treated to a delicious potluck lunch brought in by my staff here for Bosses Day. Yep, I'm getting fatter!

Well, that's it. A rambling recount of the latest happenings in our little world. I can't wait to see what next week will bring. Go Cardinals!

Monday, October 10, 2011

Indoor Cats Need Vets Too!

A recently-published survey done by the Brakke Consulting Group has identified a disturbing trend in pet care. It seems that many cat-owners, especially those with indoor cats, do not seek routine veterinary care for their pets. The study sites a number of reasons for this behavior: people are using the internet to self-diagnose (and treat?) sick cats, cats hate going to the vet, the economy makes people less likely to spend money on vet visits, and most-disturbingly, they feel like indoor cats don't really need veterinary care.

I want to focus here on the first and last reasons given. What most people don't realize is that a sick cat will often be sick for days, to weeks, to months before the owner notices. Why? Because a sick cat often acts about the same as a not-sick cat! Cats sleep a lot, eat when they want (usually when no one is around), and seek out the privacy of the litter box to urinate and defecate. There aren’t many cat owners (including me) who will notice subtle variations in their cat’s bathroom, feeding, drinking, or other behaviors. They certainly aren’t nearly as easy to track as dogs! If your dog is urinating excessively, you’re cleaning up messes, or at the very least, having to let him out more. If my dogs don’t greet me when I get home, I know something is wrong. And so forth…

As a veterinarian, I know that my sick feline patients have usually been sick a lot longer than my sick canine patients, for the reasons stated above. I also know that I frequently diagnose asymptomatic cats with major health problems when I see them for routine check-ups. These cats are lucky to see me, because the prognosis is generally a whole lot better if I diagnose them before they are “overtly sick.” I know this also from personal experience with one of my own (http://horseshoepets.blogspot.com/2011/06/my-sick-cat.html ).

This is my blog topic today because this morning I discovered a heart murmur in a 3-year old feline patient (100% indoor cat!) who came in for her annual checkup (and vaccines). This cat has a high risk for having a serious problem, and the owner wouldn’t have known had they not come in. Now we can do something about it. Later, when I was walking in from lunch, one of our techs was caring for a 2-year old (100% indoor!)cat on oxygen and IVs who was jaundiced and bloated. The cat had not seen a vet since she was spayed as a kitten. We didn’t have a diagnosis yet, but just by looking at her, I knew the prognosis was grim. I couldn’t help but wonder if this couldn’t have been prevented by a simple annual check-up.

Friday, September 2, 2011

Arthritis in Dogs (and Veterinarians)

About ten years ago, a podiatrist prescribed Celebrex, an anti-inflammatory drug, (think ibuprofen) for plantar fascitis in my feet. I still have the condition, and since then I take the Celebrex as-needed. What I have noticed, however, is that as I get older, my joints are sore, and the Celebrex helps that a lot! So...I'm taking the drug more often, simply to be able to walk up the stairs in the morning without wincing in pain.
Experiencing the aging process (and the soreness that accompanies it) first-hand has made me more empathetic to my old arthritic patients. I haven't seen any statistics, but degenerative joint disease ("DJD", another name for arthritis) is an extremely common occurance in older dogs. DJD is especially debilitating in large-breed dogs, and is possibly the most common reason these dogs are euthanized.
There are a number of strategies we employ to treat DJD, and it is widely accepted that "multi-modal" therapy is most effective, although not every patient needs every form of treatment. Identifying at-risk dogs is very helpful in delaying symptoms and reducing the severity of DJD. At-risk dogs include those who have experienced bone or joint injuries in their youth (fractures, torn ligaments), overweight breeds prone to hip dysplasia, and dogs with conformational problems which could lead to abnormal stress on their joints. In my opinion, these dogs should be started on medical-quality glucosamine/chondroitin supplementation as early as possible.
Weight control and regular exercise are probably the two most important factors in preventing and treating DJD. As stated in a previous blog, dogs at ideal weights live about two years longer than obese dogs, primarily because of healthier joints. Regular exercise keeps the tissues which support the joints strong and helps the joints stay "lubricated." We have a physical therapy routine we prescribe for dogs with moderate to advanced arthritis, and some specialty hospitals even offer high-end PT (swimming, underwater treadmills, etc...)
As far as drug therapy is concerned, this is reserved for patients showing signs of pain. However, many owners don't recognize these signs! I get a lot of comments such as, "He's not sore, Doc. He just has a hard time getting up in the morning, like me." OK, Gomer, your dog is in pain. He does feel better as he starts to move around, but the pain is his body's way of saying, "There's something wrong here - I need help." Like me and my Celebrex, these dogs should be made comfortable to maximize their quality of life. We routinely use anti-inflammatories (like my Celebrex!), and supplement them as-needed with the pain reliever Tramadol.
There are now prescription diets for arthritic dogs. According to the veterinary orthopedists I have spoken with, the key ingredient in these diets is super-high levels of omega-3 fatty acids. These high levels of fatty acids have a significant anti-inflammatory effect on the joints. I am told that the levels are so high that it would be difficult to achieve them by giving fish oil, or some other fatty acid supplement. The problem is that these foods are quite expensive, especially for large dogs.
Veterinarians are now using stem cell therapy to treat arthritis. The stem cell cultures are grown from the patient's own surgically-acquired fat cells. When injected into an arthritic joint, the stem cells help control inflammation and pain, and possibly aid in the healing of damaged cartilage. While there are a lot of anecdotal success stories with veterinary stem cells, there is still a lack of hard evidence. Having said that, I recommend stem cell therapy for patients whose owners want to try everything possible. We do offer it at our practice. It aint cheap!
So if your dog, like me, is moving slowly and stiffly in the morning, or struggles to get up the stairs, or pays a big price for a day of fun and play, get him some help! He would do it for you if you were hurting.

Wednesday, August 17, 2011

Quick Thoughts On Pet Nutrition

I don't know if I have admitted it on here yet, but for a little over a year, we have been a Golden Retriever family. Our Golden (named "Baron") is really Kathy's dog, and she is his "person," but he is happy to include me in his activities when Kathy is not paying attention to him.

Anyway, as I was roughhousing with Baron this morning, I realized that he is really a very lean and muscular dog...and I am happy about that. In fact, he is pretty different from many of the large-breed dogs I see in my practice. Like people in America, our dogs are fatter than ever.

Now I know we are all tired of hearing about the health risks associated with obesity in people and in pets, so I'll keep this short and to the point. The most common reason large-breed dogs are euthanized at my practice is because of crippling arthritis, which is usually complicated (or caused) by obesity. Purina did an eye-opening study a few years ago in which two groups of Labrador Retrievers were free-fed, or fed limited quantities their entire lives. The average dog in the free-fed group lived eighteen months less than the average dog in the limited-quantity group. This means that lean Labradors live about 12% longer!

It is reasonable to extrapolate this information to all large breeds. I know that Kathy would do anything to get an extra 18 months of health for Baron. So our 80-pound dog gets 3 and 1/2 measuring cups of food per day, and a cracker-sized treat at night. The rule of thumb for feeding adult dogs is 1/2 cup of dog food per 20 pounds of dog twice a day. For puppies, it's 1/2 cup of puppy food per 10 pounds given twice a day. I have learned the hard way not to estimate the volume of food you're giving -- get an actual measuring cup to scoop the food!

A couple of quick notes on cat nutrition would be approriate here. Recently-published data shows that most cat food label directions will result in over-feeding cats. This data recommends (as do I) feeding adult cats 30% less than the label says. Additionally, we now know that there are a number of feline diseases which can be effectively treated by giving canned veterinary diets. Therefore, I recommend supplementing dry kitten or cat food with a teaspoon (or less) of canned food several times a week, just so these cats will learn to eat canned food in case it ever becomes necessary later in life.

I get asked a lot about raw-meat diets lately, and there is some debate about canned vs dry food in cats, so those will be topics of a future blog. I know, I know...my future blogs tend to be waaaay in the future. I will try to do better!

Friday, July 22, 2011

Gotta Love Pet Insurance

I have a friend who LOVES Shar Peis. She has five of the wrinkley little creatures. Now, owning a Shar Pei (by the way, "Shar Pei" is a breed of dog that is covered with wrinkles) is not for the faint of heart. These dogs have enough medical problems to keep a small veterinary practice in business all by themselves.

Anyway, my friend was telling me about her experience with her pet insurance provider, Trupanion. One of her recently-acquired pups had developed horrible ear canal disease; so much so that both ear canals had almost completely grown shut with swollen tissue. Medical therapy wasn't helping much, and the ears were miserable.

The only recourse to alleviate the suffering was to remove the ear canals altogether. The surgery is called a "total ear ablation" and required the expertise of a board-certified veterinary surgeon. As you can imagine, it wasn't cheap. I think the total cost was in the $1500 range. Right. Ouch. But the cool thing is that she had purchased a pet health insurance policy from Trupanion just after a free trial membership. She paid the bill for the surgery, then submitted the claim. Within two days she got an email telling her the claim was being processed. Within a week, she had been reimbursed for about 90% of the bill! So before the sutures were even out, the surgery was paid for, and her pup was feeling great.

This is is very typical of the feedback I get from clients who purchase pet health insurance. The premiums are reasonable, and most companies pay quickly and generously. We all know that veterinary medicine is capable of some pretty miraculous things in this new century. We also know that these miracles are only available to those with the means to pay for them. Pet insurance is a reasonable way to make the miraculous stuff available.

A few tips: 1.Buy insurance while your pet is young. Premiums will be cheaper, and there will be less chance of your pet having a pre-existing condition which won't be covered. 2.Buy a "Major-Medical" type policy that does NOT cover routine care such as shots and dental cleanings. You can plan and save for routine care, and the premiums will be much lower. 3.Some pet insurance companies will not cover certain conditions in breeds that are pre-disposed to those conditions. Check in to this before purchasing a policy.

In this age of veterinary miracles, pet insurance is your way to make sure our miracles are available to you.

Monday, June 27, 2011

My "Sick" Cat

My name is David Hall, and I'm an inconsistent blogger. It's been two months since my last blog. Hi David.

All I can say is it's been a busy summer! I'm here now, and I wanted to share a personal story about one of our family cats named "Mae". Mae is about ten years old and has lived with us almost her entire life. She started off as my oldest son Tristan's cat, then adopted my youngest son, Dylan, when Tristan moved out.

Mae is a very mellow "live and let live" kind of cat. She tolerates anything and is most happy sitting on the pillow next to Dylan as he sleeps. We had noticed that Mae seemed to be losing a little weight, but we weren't too worried about it since Mae has always struggled to maintain her ideal weight. OK, she's fat.

Anyway, when we brought Mae in for her annual check-up, labwork, and vaccines, we got an unpleasant surprise: Mae has diabetes.

The good news for Mae (and us) is that diabetes in cats can often be "cured." With a specific type of insulin (Lantis), a special diet (M/D by Hills), and monitoring and adjusting at home, any diabetic cat, if diagnosed early, has a reasonable chance of going into remission, and resuming a normal life without further insulin injections.

We have started Mae's insulin, and Dylan regularly gives her her special food. I will be teaching my wife how to get a drop of blood from Mae's toe to test her sugar levels (this has to be done four hours after the insulin when I'm typically at work). We are hopeful that we can cure her, and thankful that we did the "routine" labwork at her check-up. If Mae's diabetes had gone on undetected, we would have had a much sadder prognosis.

Wednesday, April 13, 2011

Do Animals Feel Pain?

When I was in veterinary school, we didn't talk too much about animal pain. It was a topic mostly discussed from the perspective of using analgesics ("pain-killers") to enable us to use lower doses of anesthetics in high-risk surgery patients. That's all I remember. I'm not sure we were taught this, but I do recall having a very definite impression that animals do not experience pain in the same way humans do. I do remember being taught that post-surgical pain is a good thing, at least to a certain extent, because it is nature's way of preventing the patient from doing things they aught not to.

Looking back, these concepts seem barbaric to me, although I admit that I adhered to them in my early years. Like my colleagues in the profession, I simply didn't know any better. The truth is, animals demonstrate pain very differently than people, but things that would be painful to us are just as painful to our dogs and cats. We often don't percieve that they hurt, because they can be quite adept at disguising the pain, especially cats. I have seen fascinating video footage of dogs recovering from painful surgical procedures in which they appear alert and relaxed/happy when a human is in the room, only to demonstrate obvious signs of pain and discomfort when left alone.

I am happy to report that today's veterinarians are fully aware and proactive in dealing with painful conditions. We also have numerous resources in dealing with animal pain, from narcotics and other analgesics, to physical therapy, acupuncture, massage, and local anesthetic agents, among others. There are classes, seminars, and textbooks on veterinary pain management. Veterinarians are trained to recognize potentially-painful conditions and the subtle symptoms on animal pain. Even though we have a hightened awareness of pain in our patients, it can still be tricky to diagnose.

We also know that the concept of pain as a useful mechanism to prevent an injured (or recently-operated-on)pet from doing things he or she shouldn't is mostly flawed. Pain-response studies demonstrate that patients whose pain is well-controlled have significantly shorter healing times. Similarly, arthritic patients whose pain is treated are much more mobile, which allows the joints to benefit from the "physical therapy" benefits of simple activities such as walking and running.

Wednesday, March 30, 2011

Cats That Pee On The Floor

I love cats. I have three at my house! Having said that, for some animal-lovers, the point of choosing a cat instead of a dog is to avoid dealing with the whole housebreaking thing. Cats use litter boxes, therefore no one needs to be home to let them outside to "do their business." Ah, but as with so many things in life, the cat doesn't always stick to the plan. At our hospital we see several cats a week for what we term "litter box avoidance."

We can generally classify the causes of litter box avoidance as either due to bladder pain (physiologic), or due to environmental factors (behavioral). Most of us who have ever had a UTI can relate to the bladder pain issue. These cats feel pain which they associate with urination, which they associate with the litter box. So they avoid the litter box. They also may feel like they have to "go" all the time, and they just can't make it to the box. We can usually tell which cats fall in this category based on the history (frequent, small-volume urination; vocalizing when urinating), and urinalysis results which show evidence of inflammation in the urine (usually increased red or white blood cells).

Once we determine that a cat has a bladder problem, we can bet that it's one of four things: an infection (UTI), a stone, a tumor, or "interstitial cystitis" (IC). You all know what the first three are, but probably haven't heard of interstitial cystitis. "IC" goes by many other names (Feline Urologic Syndrome, Feline Lower Urinary Tract Disease, Idiopathic Cystitis) which usually means, as in this case, that not much is known about it. The disease causes pain and inflammation in the bladder (including the presence of blood, crystals, or other substances), and in male cats can lead to urethral obstruction and the life-threatening inability to urinate.

Current thinking is that IC is a stress-associated condition which only occurs in certain predisposed cats. But we really don't know. There is no good treatment, but the symptoms often run their course, sometimes to reoccur later. The best therapy in my hands is feeding canned food exclusively (preferably Science Diet C/D --I really think it helps!) and the anti-anxiety drug amitriptylline. Encouraging a cat's natural predatory instincts (hunting, stalking prey) also seems to help. This can be accomplished by letting the cat chase a string, toy mouse, etc...

Diagnosing IC is also challenging. Here are my guidelines for diagnosing/treating cats with bladder inflammation. First of all, I know that UTI's and IC are far more common than stones and tumors; furthermore, UTI's are more common in old cats (and diabetic cats), while IC is more common in young cats. So if the cat is old or diabetic, I will try antibiotics first and see if things get better. If the cat is young, I will treat for IC first. If treatment is not successful (in either case), I will take an X-Ray to look for a stone. If there is no stone, I might do a urine culture to verify the presence or absence of bacteria (UTI). If all tests and treatments are unsuccessful, and the cat still has blood (or other stuff!) in the urine, I will recommend an ultrasound to look for a tumor. Again, with IC, all tests will be normal.

One thing that bothers me is when vets automatically put all cats with blood in the urine on antibiotics. If the cat is young, it probably does not have a UTI. When the cat is rechecked a few weeks after the antibiotic, it may be better. This is not due to the antibiotic, but because of the waxing-waning nature of IC. Even though antibiotics are generally safe, their indiscriminate use can lead to the development of resistant strains of bacteria. And that is becoming a big problem in our country.

As I mentioned at the beginning, some cats who have "litter box avoidance" have normal results on their urinalysis. I generally classify these cases as behavioral. They may be avoiding the box because they don't like the box (it's not clean enough, they don't like the cat litter, they don't like sharing it with other cats, it is not in a "private" enough location, etc...), or something else has upset them and they are showing their displeasure by urinating in inappropriate places. This might be due to a new pet or person in the house, a strange cat in the yard (cats love to look out the window), or some other change in their routine. It could also be due to the cat not feeling well. Sometimes the first sign of serious illness in a cat is litter box avoidance. For this reason, these cats should always be checked out by a vet.

Believe it or not, litter box avoidance is a fairly common cause of euthanasia in cats. I hope this blog helps shed some light on the issue.

Monday, March 28, 2011

A Tribute To My Staff

I have to say, I really love my job. It is a rare day that someone doesn't tell me they've wanted to be a veterinarian at some point in their life. As an animal-lover, nothing could be better than going to work to help sick pets or keep pets from getting sick. But among veterinarians, I think I am more blessed than most, thanks to the people I work with every day.

I try to be a guy who appreciates all his blessings, but a particular incident last week really made me realize how cool it is to work at Horseshoe Lake Animal Hospital. I was doing a physical exam on a cat, and talking to her owner when we heard a bit of commotion coming from the back of the building. We stopped talking to try to figure out what the noise was.

At first it was difficult to discern, but after a few moments we realized we were listening to female voices singing, and the singing was, well, enthusiastic. As we listened more closely, the client looked at me and said, "You give love a bad name." I was definitely thrown off by her remark and said, "Excuse me?" "You Give Love A Bad Name. The Bon Jovi song. That's what they're singing," she said. Ok, that was a relief; and as I listened to them, I couldn't help but laugh out loud.

I have no idea what prompted the singing, but my client looked at me and said this must be a really fun place to work. My tech and I had to agree that it was. The people who work here are seriously underpaid - they're all here because they love what they do. It is pretty stressful at times, because our standards are high, and we take our responsibility to our patients and their owners very seriously. Not to mention this is a ridiculously busy place. But in spite of it all, we really like each other, and our jobs.

I'm also a drummer in a rock 'n roll cover band, and whenever we play out, about twenty or more people from work show up to socialize and dance. I love the show of support for me, and the fact that after spending a whole week together, these folks want to hang out. They get a little crazy sometimes, but that just makes me all the more impressed by the serious work they do at the hospital. It is the perfect example of knowing when to have fun, and when to bear down. And it makes me one lucky veterinarian.

Wednesday, March 9, 2011

Pig Ears Recalled Due to Salmonella

This just in...

Associated Press
The following recalls have been announced:


DETAILS: Pig ear dog chews manufactured by Jones Natural Chews Co. of Rockford, Ill., and shipped to distributors and retailers in Connecticut, Iowa, Illinois, Massachusetts, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, New Jersey, New Mexico, New York, Pennsylvania, Virginia, Washington and Wisconsin.

WHY: The chews may be contaminated with salmonella, which can cause nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever in people, and cause pets to feel lethargic and have diarrhea or bloody diarrhea, fever and vomiting.

INCIDENTS: None reported.

HOW MANY: 2,705 boxes.

FOR MORE: Call 877-481-2663.

Monday, February 28, 2011

Giardia--The Parasite Your Vet May Not Be Looking For

First of all, I want to apologize for another "parasite blog." I'm really not all that preoccupied with small creatures that invade our pets (and sometimes us). It's just that I received a report last week summarizing the number and types of parasites found from our patients' fecal tests over the past two months. The report was furnished by our outside lab service (Antech Diagnostics). I was stunned to see that 17% of the patients were infected with Giardia. That's almost one out of every five. Statistics from all St. Louis-area practices showed a slightly lower infection rate of 14%.

There are a couple of things that make these numbers highly significant. First of all, Giardia is one of those parasites that is contagious to people. Giardiasis is typically mild in humans with diarrhea as the primary symptom. Additionally, getting Giardia from a family pet is uncommon, with only a few documented cases. Having said that, Giardia infections in immune-compromised persons (people with AIDS, chemotherapy patients, very old or young people) can cause devastating, even life-threatening illness. The other significant thing to note is that most veterinarians do not routinely test for Giardia.

Giardia can sometimes be detected on routine fecal floats done by most veterinarians, but more often than not, the fecal float will not detect the parasite, even if it's done properly. The most accurate way to find Giardia is by performing a specific test (called an ELISA) to look for it.

At our hospital, we strongly urge Giardia testing on all new pets. We offer the test as an optional service to all pets on an annual basis. Many veterinarians do not recommend Giardia testing on asymptomatic pets. This is probably because they think it isn't very common (wrong!), or that their fecal flotation tests will detect it (less than 50% of the time!) In light of the report I received, we might start pushing pet owners to test for this parasite every year. We have a link on our hospital website with more information on Giardiasis: http://www.horseshoepets.com/giardia.html

Monday, February 7, 2011

Killed By Our Own Pets?

One of my favorite people sent me an article from aolnews.com, titled "Letting Sleeping Dogs Lie in Your Bed Can Kill You" . The article quotes the chief veterinarian from the California Department of Health as well as a veterinary professor at UC-Davis. They are both experts on zoonotic diseases, which are diseases that can be transmitted from animals to people.

The article is factual and well-written, but seems maybe a little distorted in terms of the fears that it may raise in people about their relationships with their pets. It is true that there is a growing concern among DVMs about zoonotic diseases, and at my practice it is policy for the doctors to discuss with pet owners ways to reduce the risks of zoonotic infections. I will describe for you my recommendations for you to enjoy a cuddle-y relationship with your pets without being afraid of catching something.

Be aware that the most common zoonotic pathogens (at least in the Midwest) are intestinal parasites (roundworms, hookworms, and giardia are the ones we see). These parasites produce eggs which are passed out in the pet's feces. The eggs then get in the soil and are picked up by people if they get some of the "contaminated" dirt on their fingers, then put their fingers in their mouth. To reduce your risk: 1.Pick up your pets' feces daily to reduce the risk of eggs getting in the soil 2.Practice good hygiene - no fingers in mouths, wash hands before eating 3.Keep your pets on heartworm/parasite control products every month. I recommend Sentinel for dogs and Revolution for cats 4.All new pets should have a fecal float and giardia test done before being brought home 5.All pets should have fecal floats +/- giardia tests done at least once a year 6.Puppies and kittens should be dewormed multiple times before they reach 16 weeks of age.

Dogs who live near rural areas where there are raccoons, opossums, deer, livestock, or even rodents; or who are at risk for drinking or swimming in any standing water, should be vaccinated for leptospirosis. All pets should be vaccinated for Rabies.

Do not let your pet lick your face or any open sores on you. Control potential flea infestations with monthly flea-control products (again, I recommend Sentinel and Revolution). Pregnant women should not clean litter boxes, and litter boxes should be scooped out daily.

Special precautions should be taken by immune-compromised people living with pets. This would include HIV-positive individuals, people on chemotherapy, people receiving dialysis treatments, the very old and infirmed, and infants. These special precautions should be discussed with the veterinarian and also the attending physician. Not to "toot my own horn," but I find that in the majority of situations, the veterinarian is more knowledgeable than the physician regarding zoonoses.

This sounds like a long list of precautions, but most of them are simple and inexpensive. I know how much I enjoy snuggling up to my dogs and cats, and I do so with confidence knowing my risk of "catching something" is virtually nil.

Wednesday, January 26, 2011

Veterinarians and "Doing the Right Thing"

OK. I have learned something new about myself: I'm not a very faithful blogger! No one wants to hear my excuses, so I'll move right on to my current topic, "Doing the Right Thing."

Being a veterinarian is incredibly rewarding in many ways. It really feels like a privilege to have this job. I have always felt that it also carries an obligation to "give back" to pets who need help that have no way of getting it without the assistance of a compassionate veterinarian and veterinary team. I enjoy this aspect of my profession as well. It feels good to provide assistance to sick/injured animals who are so trusting of us.

About a year ago, we were brought a very unhealthy puppy who had been found abandoned in a garbage can. My associate, Dr Chris Randla, treated his injuries and oversaw his care as he recovered. The story gained widespread recognition, and a children's book, "Tommy The Throwaway Dog" has been published to tell the story. Around the time the author, Laura Marlowe, came to our area for a book signing (Tommy was there too), we had a similar situation brought to us.

A dog was found in a rural part of our county, staggering along a fence row with an arrow all the way through his abdomen. His owner was located through a microchip, but she didn't want the dog back. Hope Rescues took him and brought him to us for emergency surgery. His spleen and part of his small intestine were removed by Dr Wendy Mollet, and he was treated for peritonitis. He now lives with a physician in a fancy St Louis suburb.

We work closely with several humane organizations to help dogs and cats in trouble. In my opinion, the humane organizations (Partners 4 Pets, Metro-East Humane Society, Hope Rescues, APA) do the hard work of caring for these animals day-in and day-out. The least we can do is lend medical advice and treatment. The humane organizations do get charged for our services, but at a deep discount. We cheerfully lose money on these cases. In addition to this, each doctor at our hospital has a $1,000 Client-Assistance account to help pay medical expenses for pets whose owners show a sincere desire to treat them, but cannot afford all that is needed. The client assistance money is provided by our hospital.

Now, it sometimes gets ugly when someone we've never seen before has a pet that has probably never seen a veterinarian, and now it is sick. Or injured. The person usually comes rushing in demanding treatment. We tend to be less sympathetic in these cases, and immediately we are called "heartless" and "in it for the money." My opinion is that this is a person who never saw to the care of her pet until disaster struck, and now feels it should be our problem. I usually recommend the owner turn the pet over to a humane organization who we WILL work with to help. It may sound "snooty," but I truly feel that pet ownership is a big responsibility, and an irresponsible pet owner does the pet a disservice.

In the meantime, we'll keep trying to "do the right thing."

And I'll try to be a better blogger.